Requisition No: 833446
Agency: Department of Health
Working Title: OPERATIONS SERVICES MANAGER - SES - 64083394
Pay Plan: SES
Position Number: 64083394
Salary: $44,060.11 - $96,940.49
Posting Closing Date: 08/11/2024
Total Compensation Estimator
DEPARTMENT OF HEALTH
DIVISION OF DISABILITY DETERMINATIONS
INTERNAL AGENCY OPPORTUNITY
ANTICIPATED VACANCY
TITLE: OPERATIONS SERVICES MANAGER - SES
POSITION LOCATION: TALLAHASSEE/LEON COUNTY (CAIII)
POSITION #: 64083394
SALARY: $44,060.11 - $96,940.49
Your Specific Responsibilities:
Coordinates and directs the activities of a unit of Claims Adjusters/Examiners/Investigators to ensure that operational objectives are met in terms of the quantity, quality and timeliness of work performed.
Reviews and analyzes case management data for the purpose of evaluating each claims examiner by established criteria regarding performance requirements and program goals and expectations. Communicates on a regular basis with claims examiners and provides quarterly assessments to each assure that the criteria expectations are understood. Provides quarterly assessments to each claims examiner regarding his/her performance. Takes appropriate corrective action as necessary.
Maintains a cumulative record of each claims examiner’s performance data for the purpose of conducting probationary, quarterly, annual or special performance evaluations.
Reviews case files at various points in the development and adjudicative process to ensure that all actions taken are appropriate and adhere to the rules of Process Unification. Assesses a variety of documents in the case file to determine evidentiary sufficiency and compliance with Social Security law and regulations.
Assures compliance with timeliness targets through assessment of the claims examiner’s development techniques by reviewing cases at specified ages, e.g., outside the parameters of the office profile, and by providing input on development and advice on alternative actions.
Maintains quality by reviewing cases at various stages of development and using the formal review system established for the area office, along with targeted reviews or formal studies. Initiates any necessary corrective action designed to improve quality.
Coordinates training for new and experienced claims examiners in the unit. Provides ongoing training for claims examiners as required to explain new or revised medical, vocational and technical instructions, or to reinforce previously acquired knowledge. Assists in the area office training.
Monitors closely management reports on the expenditure of funds used to purchase medical evidence. Assures optimum cost effectiveness through reviews of requests for purchase of consultative examinations and special testing to determine appropriateness and need.
Routinely studies publications of Social Security and State agencies pertaining to the program to keep abreast of new developments and changes in medical and vocational aspects of disability.
Role of the Position :
The role of this position is to manage, direct and supervise a unit of claims examiners who develop and adjudicate initial, reconsideration and continuing disability review level disability claims under Titles XIX (Medically Needy Program) of the Social Security Act. The position is responsible for the planning, coordinating, implementing, evaluating and monitoring activities necessary to effectively direct the section of claims examiners to ensure that the policies, procedures, and goals established by the Compensation & Benefits Manager and the Social Security Administration are adhered to and met by the unit.
Examples of Independent Decisions and Their Effect :
Example
Reviews case files at various points in the development and adjudicative process to ensure that all actions taken are appropriate, adhere to the rules of Process Unification, and are compliant with Social Security law and regulations.
Effect on agency, public, etc.
Actions taken as a result of this review establish procedures which affect decisions in subsequent case management that result in the payment of nonpayment of disability benefits to a claimant. Adherence to the rules of Process unification results in consistency of the decision making process among all claims examiners’ processing Social Security disability claims.
Example
Assures compliance with timeliness targets through assessment of the claims examiner’s development techniques by reviewing cases at specified ages, e.g., outside the parameters of the office profile.
Effect on agency, public, etc.
Actions taken as a result of this review establish procedures to prevent undue delay of disability decision notice to claimant of payment or nonpayment of benefits.
Example
Reviews and analyzes case management data for the purpose of evaluating each claims examiner by established criteria regarding performance requirements and program goals and expectations, and for the purpose of improving performance.
Effect on agency, public, etc.
Corrective actions taken as a result of review and analysis of performance have a direct impact on the quality, quantity and timeliness of the work performed by the program and the decisions affecting payment or nonpayment of benefits to the claimants
Example
Monitors closely management reports on the expenditure of funds used to purchase medical evidence.
Effect on agency, public, etc.
Actions taken on this review have the potential to result in an improved selective process in the expenditures or savings of monies budgeted for the purchase of medical evidence.
Responsible for the supervision of staff including appraisals, planning and directing their work, approving leave, and having the authority for hiring and taking disciplinary action of effectively recommending such actions.
Required Knowledge, Skills, and Abilities:
Knowledge of the procedures and requirements for reviewing and analyzing Social Security determinations for compliance with applicable rules, regulations, policies and procedures.
Knowledge of anatomy, physiology, function, dysfunction and disease processes.
Ability to understand and apply applicable rules, regulations, policies and procedures.
Ability to monitor claims processing for compliance with applicable policies and procedures.
Ability to manage a disability program section.
Qualifications:
Must be a current Division of Disability Determinations employee.
At least three years’ experience adjudicating Social Security or Medically Needy disability cases.
Adjudicated all levels of Social Security or Medically Needy disability cases (including Continuing Disability Reviews).
Florida Department of Health Mission, Vision, and Values:
Mission:
To protect, promote & improve the health of all people in Florida through integrated state, county & community efforts.
Vision:
To be the Healthiest State in the Nation.
Values:
I nnovation: We search for creative solutions and manage resources wisely.
C ollaboration: We use teamwork to achieve common goals & solve problems.
A ccountability: We perform with integrity & respect.
R esponsiveness: We achieve our mission by serving our customers & engaging our partners.
E xcellence: We promote quality outcomes through learning & continuous performance improvement.
Where You Will Work:
Talllahassee
The Benefits of Working for the State of Florida:
Working for the State of Florida is more than a paycheck. The State’s total compensation package for employees features a highly competitive set of employee benefits including:
(For more information, please click );
For a more complete list of benefits, including monthly costs, visit .
Please be advised:
Your responses to qualifying questions for this position must be verifiable by documentation provided through the electronic application process.
This position requires a security background check and participation in direct deposit.
Your conditional job offer and access to Social Security Administration’s (SSA’s) systems, data, information, and/or premises are contingent upon you passing the SSA suitability process.
*Note: This covers the preliminary screening (pre-screen) and the final background adjudication stage of the suitability process.
Any misrepresentations or omissions will disqualify you from employment consideration. Note: You will be required to provide your Social Security Number (SSN) in order to conduct this background check. Successful completion of a drug test is a condition of employment for safety-sensitive positions.
Male applicants born on or after October 1, 1962, will not be eligible for hire or promotion unless they are registered with the Selective Services System (SSS) before their 26th birthday, or have a Letter of Registration Exemption from the SSS. For more information, please visit the SSS website:
If you are a retiree of the Florida Retirement System (FRS), please check with the FRS on how your current benefits will be affected if you are re-employed with the State of Florida. Your current retirement benefits may be canceled, suspended or deemed ineligible depending upon the date of your retirement.
The successful candidate will be required to complete the Form I-9 and that information will be verified using the E-Verify system. E-Verify is operated by the Department of Homeland Security in partnership with the Social Security Administration to verify employment eligibility.
Incumbents may be required to perform emergency duty before, during, and/or beyond normal work hours or days.
The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer and does not tolerate discrimination or violence in the workplace.
Applicants requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center (1-877-562-7287). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation.
The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act.
Florida has the third largest population of veterans in the nation with more than 1.5 million service men and women. The Florida Department of Health (department) is committed to serving members of the United States Armed Forces, veterans and their families by encouraging them to apply for vacancies that fit their area of knowledge and/or expertise. Through the Department's VALOR program, which expedites licensing for military veterans, the Department also waives initial licensing and application fees for military veterans who apply for a health care professional license within 60 months of an honorable discharge. These initiatives help ensure that the transition from military service into the workforce is as smooth as possible and reflects our appreciation for the dedication devoted to protecting our country.
The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer, and does not tolerate discrimination or violence in the workplace.
Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center (1-866-663-4735). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation.
The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act.
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